Yet Heller, the only Republican senator facing re-election next year in a state Democratic presidential candidate Hillary Clinton won, argued against substantive changes to a host of Obamacare provisions and offered an amendment to protect the status quo at the heart of the law — its expansion of Medicaid.

“Let me tell you the impact Medicaid has had on the state of Nevada,” he said. “And as many of you know, the state of Nevada was the first state to expand Medicaid. Before the state made that decision, the state’s uninsured rate was at 23 percent, one of the highest in the country.”

Most Republicans argue that the Medicaid expansion has weakened the financial integrity of an already-shaky entitlement program. But Heller insisted he opposes the Affordable Care Act.

“Make no mistake, Obamacare needs fixing,” he said. “It’s led to higher costs and fewer choices in my state. For the past seven years, I’ve said we need more competition to drive down costs and increase choices for Nevadans.”

Several conservative activists ripped Heller and six other Republicans who joined Democrats in voting down the repeal — Arizona’s John McCain, Maine’s Susan Collins, Alaska’s Lisa Murkowski, Ohio’s Rob Portman, Tennessee’s Lamar Alexander, and West Virginia’s Shelley Moore Capito.

“Today, seven Republican Senators betrayed their constituents and the American people by breaking what is arguably the biggest political promise in modern American politics, and refusing to vote to repeal Obamacare,” Tea Party Patriots co-founder Jenny Beth Martin said in a prepared statement. “For the last four election cycles, Republican candidates have promised to repeal Barack Obama’s signature legislation and as a result, have increasingly been granted more power in Washington by the American people.”

Of the seven, only Collins had voted in 2015 against a similar measure, which would immediately end the individual insurance mandate. Extra money authorized to expand Medicaid and help lower-income Americans buy private insurance would be repealed beginning in 2020. FreedomWorks President Adam Brandon blasted the other six.

“We now know that these six senators are Obamacare repeal frauds,” he said in a statement. “Even though we’re still wondering if Sen. Susan Collins is in the right party, at least she was consistent with her vote.”

“We now know that these six senators are Obamacare repeal frauds.”

Heller’s amendment called for protecting the Medicaid expansion and preventing changes to a funding split in which the federal government pays 90 percent of costs to cover the expansion population. It failed after a procedural objection.

The Senate also rejected an amendment by Sen. Bob Casey (D-Pa.) to send the bill to the Senate Finance Committee with instructions to examine the health care law and explore changes that would not harm people with disabilities. He said he did not believe Heller’s “sense of the Senate” resolution was strong enough.

“We need more than sentimentality here,” he said. “We need more than good wishes.”

Democrats argued that cuts to Medicaid under the repeal proposal — on the anniversary of the day the Americans with Disabilities Act took effect — would hurt the disabled.

“You can’t just have rights that are guaranteed without the support for those rights,” Casey said. “Medicaid provides that support.”

The Senate will continue debating and considering amendments, but Democrats complained that they do not like what they are amending. Indications are that the Senate eventually will vote on a so-called “skinny repeal” that would eliminate the unpopular mandate that people buy insurance and a few other provisions.

But Senate Minority Leader Chuck Schumer (D-N.Y.) said Democrats would not participate in a “sham of an amendment process” until Republican leaders produce text of the underlying bill they plan to vote on.